Eydawn Posted November 26, 2007 Share Posted November 26, 2007 Damn! It was worth a shot. All I could think of improvising, really! Bummer. Wendy CO EMT-B Link to comment Share on other sites More sharing options...
CC64 Posted November 26, 2007 Share Posted November 26, 2007 Damn! It was worth a shot. All I could think of improvising, really! Bummer. Wendy CO EMT-B It's surprising, how much stuff you have to have in order to improvise... Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted November 26, 2007 Author Share Posted November 26, 2007 The helicopter team came with all the bells and whistles but they forgot to put on a medically trained person. So they also have a nice hoist for you to swing this guy around in. You are hooked up to the hoist and along with two other rescue randy's from the helicopter you make it to the patient. Once there here is what you find. open fractures of both femurs and tib/fibs open fracture of the upper arm and radius and ulna. A large gash in the forehead and a gash with what feels like a fragmented area underneath the laceration - possibly indicative of a skull fracture What else do you want to know. Link to comment Share on other sites More sharing options...
Chief1C Posted November 26, 2007 Share Posted November 26, 2007 Conscious? Estimate of blood loss? are the limbs viable, i.e. w/ pulse/sensation, any obvious internal problems, breathing still? "Send down the MAST" Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted November 26, 2007 Author Share Posted November 26, 2007 Conscious? Estimate of blood loss? are the limbs viable, i.e. w/ pulse/sensation, any obvious internal problems, breathing still? "Send down the MAST" Semi conscious blood loss > than 2 liters - the sand is soaked no pulses in left lower leg pulses in other leg and arm patient is breating but seems to be grunting and really working to breathe and miraculously your studious EMT/volunteer fireman thought to bring the mast pants - they are being lowered down. Link to comment Share on other sites More sharing options...
CC64 Posted November 26, 2007 Share Posted November 26, 2007 Vitals? Breath sounds? I'm worried about him having a collapsed lung. Any trachea deviation or JVD? Be prepared to have to do a needle decompression. I'd disagree with the MAST pants. (people still use them?) Multiple open long bone fractures...this guy is sick. Easiest thing to do would be 2 large-bore IVs, pump him full of fluids and whatever else the ALS protocols call for and you can get away with from med command. The LBB is a whole-body splint, so put him on that, get him to a trauma center ASAP. Consider airway support. Link to comment Share on other sites More sharing options...
Chief1C Posted November 27, 2007 Share Posted November 27, 2007 I'd disagree with the MAST pants. To splint the lower extremities, not for shock.. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted November 27, 2007 Author Share Posted November 27, 2007 Vitals? Breath sounds? I'm worried about him having a collapsed lung. Any trachea deviation or JVD? Be prepared to have to do a needle decompression. I'd disagree with the MAST pants. (people still use them?) Multiple open long bone fractures...this guy is sick. Easiest thing to do would be 2 large-bore IVs, pump him full of fluids and whatever else the ALS protocols call for and you can get away with from med command. The LBB is a whole-body splint, so put him on that, get him to a trauma center ASAP. Consider airway support. Vitals bp 60 palp pulse 140 resp 8 pulse ox - cannot read Cardiac monitor - sinus tachy Trachea deviated to left loc - near unconscious and unresponsive You all see where this is goin you put the pt. in mast pants 2 large bore iv's wide open Do you intubate or not? Stokes basket on it's way down Now what? Link to comment Share on other sites More sharing options...
CC64 Posted November 27, 2007 Share Posted November 27, 2007 Well, (being that i'm slightly tipsy at the moment, please excuse any gross misspellings) needle decompression to treat the pneumothorax on his right lung. Where to stick the needle, I do not know. assist ventilations with a BVM; if they don't improve, intubate with the advanced airway adjunct of your choice (combitube, LMA, ETT). Load him up, fly to the closest trauma center...if he becomes unstable en route, then divert to closest ED for immediate stabilization. However, that also depends on local protocols. Thank everybody for their assistance. Link to comment Share on other sites More sharing options...
Dustdevil Posted November 27, 2007 Share Posted November 27, 2007 I'd disagree with the MAST pants. (people still use them?) Multiple open long bone fractures...this guy is sick. Easiest thing to do would be 2 large-bore IVs, pump him full of fluids... I'd disagree with the MAST and the fluids both. Link to comment Share on other sites More sharing options...
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